Instrument for crushing concretions in the urinary bladder



0 United States Patent in] 3,543,757

[72] Inventors Oleg Gavrllovlch Balaev 2,227,727 1/1941 Leggiadro 128/328 Prospect 40-letla Oktyabrya 100 XV. 174; 2,830,578 4/1958 DeGuff l28/24.05 Jury Grlgorievich Edlny, Rovenskaya 3,413.976 12/1968 Roze 128/328 21 A l N Kiev Primary Examiner-Louis G. Mancene g' p i 6 1965 Assistant Examiner-Gregory E. McNeill [45] Patented Dec; 1 1970 Attorney Waters, Rodltl, Schwartz & Nissen [54] INSTRUMENT FOR CRUSHING CONCRETIONS IN THE URINARY BLADDER 4 Claims, 2 Drawing Figs.

ABSTRACT: An instrument for crushing stones In the urinary U-Su ..-......-\-...-...-........----.."...-a bladder used ogether a cystoscope comprises a genera. [5| 1 P- Cl 17/00 tor of electrical oscillations connected with a magnetostrictive [50] Fleld of Search 7. 128/328, converter of the electric oscillations to ultrasonic 0Si||a 3411 353, I tions which in turn is connected with a concentrator exciting 4 I 300-14 an elongated lithotrite having an elastic conductor enclosed in a waterproof catheter with a working member at the end of [56] References cited the conductor. introduced through the cystoscope, to form a UNITED STATES PATENTS connection between the oscillating working member with the [82,398 10/1932 Pierce..... 1.

stone which results in crushing of the latter.

PILOT LAMP Patented Dec. 1, 1970 3,543,757

/Z 5 T? 1 I 1 POWER 5 P/LOT 2 ZZZT 244 LAMP E I J: A i g r 2 RELAY PECT/F/ER INSTRUMENT FOR CRUSHING CONCRETIONS IN THE 1 URINARY BLADDER This invention relates to instruments for crushing concretions in the urinary passages and more particularly to instruments for crushing stones in the urinary bladder.

Some mechanical means for crushing stones in the urinary .bladder are known such as lithotrites and cystolithotrites.

However, these devices cannot be used for crushing friable stones (phosphates, carbonates) of more than 30 mm. in diameter or dense calculi (oxalates, urates) sized over -20 These mechanical means cannot be used for the urinary bladders whose capacities are less than 100-80 ml. The

process ofcrushing is rather labour taking and causes painful sensations in the patient. The operation does not exclude possible traumas on the bladder walls and besides it does not allow to apply cystoscopic or X-ray control of the crushing process. In addition to these, there are some other disadvantages which hinder the effective use of said instruments.

Attempts havebeen made to improve the instruments for crushing concretions in the urinary bladder by elongating the lithotrites and rendering them mechanical vibrations of say ultrasonic frequency, but none of them has proved reliable or convenient in practical use.

Therefore an object of the invention is to develop an instrument for crushing stones in the urinary bladder which would be reliable in use and would allow to visually control the process of crushing Another object of this invention is to develop an instrument ensuring crushing of stones with small amounts of the washing fluid in the urinary bladder and in cases of cancer and adenoma of the prostrate.

Still another object of the invention is to develop an instrument for crushing stones in the urinary bladder which would be convenient to control and safe in use.

The principal object of the invention is to develop an instrument for crushing stones in the urinary bladder safe and reliable in operation provided with an elastic thin lithotrite which can be inserted into the urinary bladder through the opening in a cystoscope.

Said principal object is achieved due to the fact that the instrument for crushing stones in the urinary bladder according to the invention comprises a generator of ultrasonic electric oscillations connected with a device for its remote control through a grounding system connected with a supply circuit of the cystoscope lamp, a converter of the electric oscillations to mechanical ones and a device for concentration of the mechanical oscillations, all said devices being connected in series, while the lithotrite has an elongated elastic conductor of mechanical oscillations which is connected with the oscillation concentrator and mounts on its end a working member partially enclosed into a protective waterproof catheter together with the conductor.

Said catheter can have a spiral wound round the conductor attached to the shank of the working member and enclosed in the elastic tube of heat-resistant material hermetically joined with the shank of the working member.

The percussive element of the working member should preferably be made as a hollow cylinder having a side opening. A magnetostrictive nickel converter should be used as a converter of oscillations and an exponential concentrator as a device for concentrating oscillations.

The lithotrite conductor should preferably be attached to the concentrator of oscillations by means of a low-melting compound with an electric heater installed in the zone of the connection.

For a better understanding of the invention it will further be illustrated by a description of an embodiment thereof and the appended drawings in which:

FIG. 1 shows a circuit diagram of the instrument intended for crushing stones in the urinary bladder; and

FIG. 2 is the lithotrite ofthe instrument shown in FIG. 1 (in section).

The instrument of the invention for crushing stones in the urinary bladder comprises a generator 1 (FIG. 1) of electrical ultrasonic oscillations connected with a power supply unit 2.

The generator 1 is connected with a magnetostriction nickel converter 3 in which the electric ultrasonic oscillations produced in the generator 1 are transformed into mechanical oscillations and after being amplified in an exponential concentrator 4 are transferred to the conductor 5 of the lithotrite. The end of the conductor 5 mounts a working member 6 which comes in contact with the concretion to be crushed. The lower portion of the conductor 5 is wound round with a spiral 7 (FIG. 2) which is attached to the shank of the working member 6 and is enclosed in an elastic tube 8 of heat-resistant material hermetically joined to the shank of the working member 6 through packing 9.

The spiral 7 with the tube 8 and packing 9 form a protective waterproof catheter for the portion of the lithotrite which will be introduced into the urinary bladder.

The percussive member of the working organ is made as a hollow cylinder having a bypass opening 10 in the wall serving for removal of crushed concretions.

A provision is made in the instrument for easy replacement of the lithotrites. For this purpose the conductor 5 is connected with the oscillation concentrator 4 by means of lowmelting solder. The zone of connection of the conductor 5 with the concentrator 4 is surrounded by a heating element 11 (FIG. 1) controlled through a time relay 12.

To replace the lithotrite the heating element 11 is turned on and a pilot lamp 13 is lighted up. As soon as the solder has melted (in about 30 to 40 see.) the lithotrite is easily detached and another lithotrite is secured instead.

After replacement of the lithotrites the time relay 12'automatically cuts off power supply to the heating element 11, the

junction site is consolidated on cooling and the pilot lamp 13 goes down.

The power source of the illuminating lamp 14 of the cystoscope 15 is the secondary winding of the down-step transformer 16. Voltage from said secondary winding is supplied to the lamp 14 through a regulator 17 and a protective grounding system comprising a clamp 18 with two mutually insulated contact elements 19 and 20. By means of these elements 19 and 20 the clamp 18 is secured to the grounding bus bar 21 connected with the housings of the instrument and the cystoscope by means of wires 22 and 23.

One of the contact elements 19 of the clamp 18 is insulated from the clamp and secured fixedly, while the other element 20 can move along threads. Another pilot lamp 24 is connected in parallel with the supply circuit of the lamp 14 of the cystoscope 15 and is intended for quick troubleshooting in this circuit.

The generator 1 of ultrasonic oscillations is remotely controlled by means of a foot pedal 25 and a relay 26 supplied through a rectifier 27. One of wires supplying the relay 26 is shorted through the bus bar 21; thus operation of the generator 1 with the ungrounded instrument is prevented. Operation of the described instrument for crushing stones in the urinary bladder is as follows.

Cystoscope 15 is introduced into the urinary bladder and the latter is filled with the washing fluid. A lithotrite is now inserted through the cystoscope 15 until its working member 6 comes in contact with the concretion to be crushed. As soon as the instrument is powered the illuminating lamp 14 of the cystoscope is lighted up.

The generator 1 is started after the foot pedal 25 is pressed upon, and the oscillations produced by said generator are transferred to the working member 6 through the conductor 5, said member crushing the stone with its impact thereupon.

The working duty of the instrument is set by the operator.

. We claim:

1. An instrument for crushing stones in the urinary bladder comprising: a hollow cystoscope with an illuminating lamp and supply circuit therefor; a lithotrite which is introduced into the urinary bladder through said cystoscope, said lithotrite including an elongated elastic conductor capable of transmitting mechanical oscillations; a working member at the end of said conductor which comes into contact with the stone to be crushed; a protective waterproof catheter at least partially enclosing said conductor and said working member; a driving means for imparting mechanical oscillations to said lithotrite, comprising a generator of electrical oscillations, a device for remote control of said generator, a grounding system between the cystoscope lamp supply circuit and the remote control device, said system including a grounded bus bar, a clamp with two mutually insulated contact elements secured to the grounded bus bar, a device for converting the electrical oscillations of said generator to ultrasonic oscillations and a coordinating concentrator of the obtained ultrasonic oscillations interposed between said converter of electrical oscillations and the conductor of the lithotrite for transmitting thereto the ultrasonic oscillations causing the vibration of said working member to cause crushing of the stone.

2. An instrument as claimed in claim 1, wherein said catheter comprises a spiral member attached to said working member and an elastic tube enclosing said spiral member and hermetically joined to said working member.

3. An instrument as claimed in claim 2 including means connecting said coordinating concentrator to said conductor of the lithotrite comprising a low-melting substance and an electrieal heating element proximate said low-melting substance to melt the same for replacement of the lithotrite.

4. An instrument as claimed in claim 3, wherein said working member comprises a percussive element of cylindrical shape with a side bypass opening, said device for converting electrical oscillations to ultrasonic oscillations comprising a magnetostrictive converter, said low-melting substance being solder, and means for remote control of said electrical heating element. 

